BACKGROUND: Data on disease characteristics, treatment patterns, and outcomes of patients (pts) >80 years (y) are rarely reported. The NLCS is a Genentech-sponsored prospective multicentre registry of FL pts without study-specific treatment. We used the NLCS database to better understand FL in pts>80 y.
METHODS: Evaluable pts with FL in the NLCS were included. Using Pearson χ,2 tests, associations of age groups with disease characteristics and response rate (RR) were examined. Median PFS and OS by treatment regimen were estimated for each age group. Cox regression adjusted for baseline disease factors and use of maintenance R (MR) were used to assess treatment differences in PFS and OS and the significance of age by treatment interactions.
RESULTS: Of 2649 pts, 209 (8%) were >80 y. Significant differences between pts >80 and <60 y were observed (table).Pts >80 y were less likely to receive rituximab (R)+chemo than all other age groups [31% vs 52% (≤60), 50% (61–70), and 45% (71–80); p < 0.001]. Use of anthracyclines was less frequent in pts >80 y vs others [29% vs 68% (<60), 65% (61–70), 50% (71–80); p < 0.001]. Use of MR was similar in all age groups (31%–36%) but was less in pts >80 who received R induction. When adjusting for MR and baseline factors, no treatment provided superior PFS in pts >80 y; in pts <60 y, R+chemo provided superiority.OS at 5 years was 59% and 92%for >80 and <60 y respectively. Cox modelling showed that lower haemoglobin (<12 g/dL) and male sex predicted worse OS (p < 0.01) but not PFS.
CONCLUSIONS: In the largest-ever published prospectively enrolled cohort of the oldest old FL pts, OS, PFS, RR, and treatment selection vary compared with younger pts.
